Disasters Averted

When traveling, “nearby” may mean closer than you think. A patient of mine, 35 years of age, with type 1 diabetes, boarded a plane. As recommended, she took her supplies, food, and treatment for a low with her in her carry-on bag. She had a window seat. She did not …

Nausea is a common side effect of GLP-1 therapy. Recently a few of my patients took the recommended low starting dose, but got so nauseated they refused treatment beyond that. From this, I’ve learned to start my patients on half the low dose of the daily or twice daily GLP-1’s …

A female patient on insulin, 67 years of age, required more and more insulin to manage her glucose levels. She was eating healthily, exercising, monitoring, and taking her insulin as prescribed. I asked her when she had last seen her dentist. She confessed that this was one part of her …

The patient, a woman, 52 years of age, has type 2 diabetes and is on metformin, a GLP-1 agonist, and a long-acting insulin. Over the past few months, I’ve received calls and emails from her every now and then to let me know her glucose levels were rising, but whenever …

A male patient, 56 years of age, with type 2 diabetes, hypertension, congestive heart failure, and sleep apnea visited. We hadn’t seen him for 6 months. His blood pressure was up, in the 140-160/90–102 range, glucose levels were higher than his targets, he was gaining weight, and continually complaining of …

A married male patient, 68 years of age, has been prescribed long-acting insulin twice a day because once-daily does not work 24 hours for him, and his dose is large. Therefore breaking it into two smaller injections helps bring down his glucose, but only when he remembers to take his …

A woman, 59 years of age, was diagnosed with diabetes while in the hospital. She was discharged on basal bolus insulin. The diabetes educator (CDE) was contacted to teach insulin administration via insulin pens upon discharge. The patient was taught, and performed return demonstration correctly. She was sent home with …

It was a beautiful day. A patient of mine who has type 1 and her friends who do not have diabetes decided at the last minute to go out and enjoy it. They walked and walked, ate out for lunch, and walked and walked some more. She walked a lot …

Years ago I was attending an annual AADE meeting in Washington, DC. It was a hot summer day in August and while running between meetings, I got overheated. One of my fellow attendees, a nurse educator who was also a friend and past president of AADE, put a cool wet …

A patient came to us on reasonably high doses of basal bolus insulin, using Levemir and NovoLog flex pens. He stated that he had been using insulin for a few months and was referred for more management assistance from his provider. He was seen by a CDE to review his …